0001562180-19-005118.txt : 20191004 0001562180-19-005118.hdr.sgml : 20191004 20191004143207 ACCESSION NUMBER: 0001562180-19-005118 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191001 FILED AS OF DATE: 20191004 DATE AS OF CHANGE: 20191004 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Sama Rinda CENTRAL INDEX KEY: 0001756399 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38721 FILM NUMBER: 191138404 MAIL ADDRESS: STREET 1: 26 TECHNOLOGY DRIVE CITY: IRVINE STATE: CA ZIP: 92618 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Axonics Modulation Technologies, Inc. CENTRAL INDEX KEY: 0001603756 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 454744083 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 26 TECHNOLOGY DRIVE CITY: IRVINE STATE: CA ZIP: 92618 BUSINESS PHONE: 949-396-6322 MAIL ADDRESS: STREET 1: 26 TECHNOLOGY DRIVE CITY: IRVINE STATE: CA ZIP: 92618 4 1 primarydocument.xml PRIMARY DOCUMENT X0306 4 2019-10-01 false 0001603756 Axonics Modulation Technologies, Inc. AXNX 0001756399 Sama Rinda 26 TECHNOLOGY DRIVE IRVINE CA 92618 false true false false Chief Operating Officer Common Stock 2019-10-01 4 S false 5000.00 26.6149 D 215627.00 D Common Stock 4000.00 I By Spouse This sale was pursuant to a 10b5-1 plan adopted by the reporting person on September 5, 2019. This transaction was executed in multiple trades at prices ranging from $26.30 to $26.70. The price reported above reflects the weighted average price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. /s/ Michael V. Williamson, as Attorney-in-Fact for Rinda Sama 2019-10-03